Publications by authors named "Sina Asaadi"

16 Publications

  • Page 1 of 1

Meningothelial meningioma of the oculomotor nerve: A case report and review of the literature.

Surg Neurol Int 2020 2;11:314. Epub 2020 Oct 2.

Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: The origin of meningioma tumors is known as the meningothelial or arachnoid cap cells. The arachnoid granulations or villi are concentrated along with the dural venous sinuses in the cerebral convexity, parasagittally, and sphenoid wing regions. The majority of meningiomas are found in these locations with dural attachment. Infrequently, meningiomas develop without dural attachment but in dural adjacent. There are numerous reports of patients with cranial nerve involvement as a result of the compressive effect of the sinus cavernous or adjacent structures meningioma tumor on the cranial nerve.

Case Description: In this study, we reviewed all reports of patients with third nerve involvement as a result of meningioma tumors in addition to the introduction of a new case. We present a 47-year-old woman presented with headache, diplopia, and ptosis. A gadolinium-enhanced mass on anterolateral of the left cerebral peduncle with no dural attachment was suggesting for Schwannoma at preoperative imaging. An adhesive 10 × 5 × 4 mm meningothelial meningioma arising from the oculomotor nerve was resected.

Conclusion: The findings of this review suggest that there may be other mechanisms as the origin of meningiomas tumors. It is crucial to take into account origination mechanisms of meningioma using ectopic meningiomas due to the increasing prevalence of meningioma.
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http://dx.doi.org/10.25259/SNI_312_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568104PMC
October 2020

The effect of adenosine in inducing cardiac arrest for endovascular treatment of paediatric high-flow brain and spinal vascular malformation.

Neuroradiol J 2020 Aug 21;33(4):328-333. Epub 2020 Apr 21.

Division of Vascular and Endovascular Neurosurgery, Iran University of Medical Sciences, Iran.

Introduction: Endovascular treatment of high-flow vascular lesions with onyx may be very dangerous due to premature occlusion of the vein resulting from high flow-induced migration of this embolic substance without occlusion of the feeding vessels and the nidus. It is also dangerous because of the risk of occlusion of the normal vessels around the lesion. Inducing temporary cardiac arrest using adenosine may be helpful in limiting and minimizing these risks. However anaesthetic management of this procedure in children suffering from high-flow vascular lesions is difficult and challenging.

Methods: We report three paediatric patients with high-flow cerebrospinal vascular lesions that underwent endovascular treatment under general anaesthesia and temporary cardiac arrest with adenosine. Adenosine was administered in escalating doses to induce a few seconds of cardiac standstill and the onyx injection was synchronized with the onset of adenosine-induced cardiac standstill, the fistula being occluded by onyx.

Results: There were no complications in peri-procedural treatment in all three cases. Post-embolization angiography revealed complete obliteration of the lesion, and the patients' neurological status progressively improved at follow-up.

Conclusion: Adenosine-induced temporary cardiac standstill was successfully used to facilitate safe and controlled endovascular onyx embolization of high-flow central nervous system vascular lesions.
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http://dx.doi.org/10.1177/1971400920920827DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416345PMC
August 2020

Dual antiplatelet therapy in a patient with simultaneous aneurysmal subarachnoid hemorrhage and myocardial infarction.

Surg Neurol Int 2020 21;11:49. Epub 2020 Mar 21.

Department of Neurosurgery, Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.

Background: Electrocardiography (ECG) changes after subarachnoid hemorrhage (SAH) are well described. However, concurrent myocardial infarction (MI) and SAH are rarely reported, and its management remains a dilemma. We report a patient with traumatic SAH concurrent with acute MI that managed successfully by endovascular intervention and dual antiplatelet therapy.

Case Description: A 47-year-old man was admitted to the emergency department with a complaint of severe headache. Diffuse SAH, with a Hunt and Hess score of 5, was noticed. ECG showed ST elevation in anterior leads, and cardiac troponin became positive. On brain computed tomography angiogram, a 6 mm anterior communicating artery aneurysm was seen. Considering the possibility of MI and SAH simultaneously, endovascular obliteration of the aneurysm was done, and then, the patient received dual antiplatelet medications until coronary angiography was done. Coronary angiography revealed normal epicardial coronary arteries. The patient was discharged with a Glasgow Coma Scale score of 15 and was visited 2 months after discharge without any new episodes of intracranial hemorrhage with a modified Rankin scale score of 2.

Conclusion: Cerebral aneurysm coiling could be considered as the first choice of treatment in the case of acute MI with hemodynamic stability, before carrying out cardiac endovascular intervention or antiplatelet medication to reduce the risk of rebleeding from a brain aneurysm.
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http://dx.doi.org/10.25259/SNI_472_2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110275PMC
March 2020

Cervical Lipomyelomeningocele Presenting with Progressive Motor Deficit: A Case Report and Review of the Literature.

Pediatr Neurosurg 2020 20;55(1):58-61. Epub 2019 Nov 20.

Department of Neurosurgery, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran,

Cervical lipomyelomeningocele is a very rare form of spina bifida occulta, which can cause some complications following tethered cord syndrome. We report a 10-year-old female with a history of progressive upper-extremity weakness, a very small soft-tissue mass at the posterior aspect of her neck, and evidence of lipomyelomeningocele in her radiological study. The patient underwent laminectomy of C6 and C7 together with resection of lipomatous tissue attaching to the cord from superficial tissue and cord untethering, which resulted in progressive improvement of her weakness.
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http://dx.doi.org/10.1159/000504059DOI Listing
November 2020

Combined Endovascular and Endoscopic Approach for Treatment of Concomitant Sphenoid Sinus Giant Traumatic Aneurysm and Direct Carotid Cavernous Fistulas.

World Neurosurg 2020 Feb 31;134:211-214. Epub 2019 Oct 31.

Divisions of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran, University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Direct carotid cavernous fistulas (CCFs) and sphenoid sinus traumatic aneurysms are well-known pathologies that can present concomitantly in rare cases. Patients with both lesions are usually symptomatic from both the CCF and the traumatic aneurysm. Symptoms include proptosis, chemosis, bruit, epistaxis, visual field defects, and loss of vision. Surgical treatment can be challenging, and for most cases an endovascular approach is the treatment of choice.

Case Description: We present an unusual case of a direct CCF with an associated large traumatic aneurysm in the sphenoid sinus due to a history of trauma presenting with unusual symptoms that was treated by a combined endoscopic and endovascular approach.

Conclusions: Concurrent occurrence of a traumatic CCF and traumatic aneurysm of the cavernous segment is extremely rare. Early diagnosis and treatment of these lesions are important considering their high mortality rate. Complete occlusion of the fistula and aneurysm while preserving the patency of the carotid artery via an endovascular approach is the treatment of choice for these lesions.
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http://dx.doi.org/10.1016/j.wneu.2019.10.131DOI Listing
February 2020

Orbital Compartment Syndrome Secondary to Direct Carotid Cavernous Fistula After Carotid Cavernous Aneurysm Rupture: Case Report and Review of Literature.

World Neurosurg 2020 Jan 14;133:409-412. Epub 2019 Aug 14.

Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Tehran, Iran; Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Carotid cavernous aneurysm (CCA) rupture is rare. However, it can result in various complications such as carotid cavernous fistula (CCF), epistaxis, spontaneous thrombosis, and subarachnoid hemorrhage.

Case Description: We report a 65-year-old woman with a history of uncontrolled diabetes who was referred with complaints of acute headache, diplopia, proptosis, and chemosis. Ophthalmic examination revealed elevated intraocular pressure in the right eye, optic disk edema, and retinal venous congestion. Canthotomy was performed based on a diagnosis of orbital compartment syndrome (OCS). Further imaging revealed a dilated superior ophthalmic vein and cavernous sinus, as well as swelling of the extraocular muscles in the right eye. Digital subtraction angiography revealed the fistulous connection between the cavernous part of the internal carotid and cavernous sinus (direct CCF) due to the large ruptured CCA, resulting in retrograde flow through the superior and inferior ophthalmic veins. Successful endovascular coiling of the aneurysm resulted in complete occlusion of the fistula. Postintervention ophthalmic examination demonstrated progressive improvement of ophthalmic signs and symptoms; however, the patient's right eye remained sightless.

Conclusions: In patients with clinical manifestation of OCS with no history of any predisposing risk factors, diagnosis of ruptured cavernous sinus aneurysm and resulting direct CCF should be considered. In such cases, emergent imaging along with early endovascular intervention can resolve OCS and prevent permanent ocular injury and vision loss.
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http://dx.doi.org/10.1016/j.wneu.2019.08.037DOI Listing
January 2020

Health-related quality of life after epilepsy surgery: A prospective, controlled follow-up on the Iranian population.

Sci Rep 2019 05 27;9(1):7875. Epub 2019 May 27.

Department of Neurology, Medical University of Aja, Tehran, Iran.

Quality of life is affected by factors such as regional differences in access to treatment choices, and rehabilitation. This study aims to assess the result of epilepsy surgery and its impact on QoL in Iran. The data for 60 patients who underwent epilepsy surgery in Loghman-Hakim hospital between 2003 to 2017 were analyzed prospectively through clinical observation. Clinical variables of interest and the WHOQOL-BREF scale to assess QoL were applied. Scores of operated patients were compared to their preoperative scores as well as epileptic patients controlled with antiepileptic drugs (AEDs) and healthy individuals. The mean age of surgery group patients was 33.78 (34 male; 26 female). Twenty seven patients underwent temporal mesial lobectomy, 20 anterior callosotomy, and 13 neocortical resections. The average QoL score in healthy group was 72.48, in AEDs controls was 56.16, and in operated patients was 65.61. In addition, analysis showed a significant increase in postoperative QoL of the surgical group compared to the AEDs controls. Epilepsy surgery could be the best approach in patients suffering from drug-resistant epilepsy even in developing countries, which can result in seizure relief and a reduction in the frequency of disabling seizures.
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http://dx.doi.org/10.1038/s41598-019-44442-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6536509PMC
May 2019

Pial Arteriovenous Fistula with Multiple Venous Aneurysms Resembling a Vein of Galen Aneurysmal Malformation; Case Report and Review of Literature.

World Neurosurg 2019 Jul 11;127:245-248. Epub 2019 Apr 11.

Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran; Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Pial arteriovenous fistulas are abnormal vascular connections between arteries and the cranial venous system on the surface of the brain in the pia mater. In contrast to vein of Galen aneurysmal malformations, they lack a true vascular nidus and may only indirectly involve the vein of Galen.

Case Description: An 18-month-old boy was referred to us with a history of seizures, drowsiness, bulging cephalic veins, and cranial nerves palsy identified as vein of Galen aneurysmal malformation according to initial magnetic resonance imaging. Digital subtraction angiography showed a vertebrobasilar junction pial high-flow fistula between the basilar artery and anterior pontomesencephalic vein, causing retrograde flow, dilation, and tortuosity of the lateral and posterior mesencephalic vein as well as the vein of Galen. Endovascular treatment, including coil embolization of fistula site, was done successfully without complication resulting in recovery from previous symptoms and signs.

Conclusions: If cerebral venous dilations are encountered, one must keep in mind that the location of the fistula may not be in close proximity to the dilated veins, especially when there is a suspicion for vein of Galen aneurysmal malformation. Other pathologies, such as pial arteriovenous fistula, in a region away from the site of the vein of Galen must be considered.
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http://dx.doi.org/10.1016/j.wneu.2019.04.061DOI Listing
July 2019

Dural Arteriovenous Fistulas with Venous Drainage Patterns Inducing Ocular Manifestations Mimicking a Carotid Cavernous Fistula: Report of 2 Cases.

World Neurosurg 2019 Jul 23;127:216-219. Epub 2019 Mar 23.

Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.

Background: Cranial dural arteriovenous fistulas (dAVFs) are abnormal connections between arteries supplying the dura mater and the cranial venous system. These present with various signs and symptoms. Progressive ocular manifestations are quite rare and may be confused with carotid cavernous fistulas (CCF).

Case Description: Here, we present 2 cases of dAVF manifesting with ocular symptomatology referred to our center erroneously diagnosed as CCF, and discuss the effect of venous drainage pattern on the clinical presentation.

Conclusions: Ocular manifestations of cerebrovascular origin are not necessarily associated with CCF or cavernous sinus dAVF. Other vascular malformations such as dAVFs should be considered specifically when accompanied by venous stenosis distal to the site of the fistula.
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http://dx.doi.org/10.1016/j.wneu.2019.03.136DOI Listing
July 2019

Nerve-Sheath-Risen Neuroglial Cyst: A Case Report and Review of the Literature.

World Neurosurg 2019 Jan 17. Epub 2019 Jan 17.

Skull Base Research Center, Department of Neurosurgery, Loghman-e Hakim hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Neuroglial cysts are rare intracranial lesions that are believed to originate from the sequestration of neural tube lining during embryogenesis. They can present anywhere within the neuraxis; however, their most common location is the frontal lobe. Cerebellopontine angle (CPA) neuroglial cysts are extremely rare and to the best of authors' knowledge, there are no previous reports of a neuroglial cyst arising from cranial nerves.

Case Description: The current study presented a male adolescent with the reoccurrence of an intracranial cyst with symptoms of diplopia and facial numbness primarily treated as CPA arachnoid cyst with fenestration of the cyst 12 months prior to admission to our center. Different magnetic resonance imaging (MRI) sequences showed a thin-walled extra-axial cyst at the right CPA without gadolinium (Gd)-enhancement. Direct visualization of the lesion revealed a cyst arising from the 5th cranial nerve sheath compressing the surrounding structures. The cyst was fenestrated and a biopsy was taken from the cyst wall. The pathological analysis along with specified histological markers indicated the neuroglial nature of the cyst.

Conclusion: The rising of a neuroglial cyst from the nerve sheath is a finding that brings other possible origins of neuroglial cysts into consideration.
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http://dx.doi.org/10.1016/j.wneu.2018.12.203DOI Listing
January 2019

The Role of BK Channels in Antiseizure Action of the CB1 Receptor Agonist ACEA in Maximal Electroshock and Pentylenetetrazole Models of Seizure in Mice.

Iran J Pharm Res 2017 ;16(2):640-647

Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

The anticonvulsant effect of cannabinoid compound has been shown in various models of seizure. On the other hand, there are controversial findings about the role of large conductance calcium-activated potassium (BK) channels in the pathogenesis of epilepsy. Also, there is no data regarding the effect of co-administration of cannabinoid type 1 (CB1) receptor agonists and BK channels antagonists in the acute models of seizure in mice. In this study, the effect of arachidonyl-2'-chloroethylamide (ACEA), a CB1 receptor agonist, and a BK channel antagonist, paxilline, either alone or in combination was investigated. Both pentylenetetrazole (PTZ) and maximal electroshock (MES) acute models of seizure were used to evaluate the protective effects of drugs. Mice were randomly selected in different groups: (i) control group; (ii) groups that received different doses of either paxilline or ACEA; and (iii) groups that received combinations of ACEA and paxillin at different doses. In MES model, prevention of hindlimb tonic extension (HLTE) was considered as protective effect. In PTZ model, the required dose of PTZ (mg/kg) to induce tonic-clonic seizure with loss of righting reflex was considered as seizure threshold. In PTZ model, while administration of ACEA per se (5 and 10 mg/kg) caused protective effect against seizure; however, co-administration of ACEA and ineffective doses of paxilline attenuated the antiseizure effects of paxilline. In MES model, while pretreatment by ACEA showed protective effects against seizure; however, co-administration of paxilline and ACEA caused an antagonistic interaction for their antiseizure properties. Our results showed a protective effect of ACEA in both PTZ and MES acute models of seizure. This effect was attenuated by co-administration with paxilline, suggesting the involvement of BK channels in antiseizure activity of ACEA.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603872PMC
January 2017

S100 B: A new concept in neurocritical care.

Iran J Neurol 2017 Apr;16(2):83-89

Anesthesiology Research Center, Loghman Hakim Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

After brain injuries, concentrations of some brain markers such as S100B protein in serum and cerebrospinal fluid (CSF) are correlated with the severity and outcome of brain damage. To perform an updated review of S100B roles in human neurocritical care domain, an electronic literature search was carried among articles published in English prior to March 2017. They were retrieved from PubMed, Scopus, EMBSCO, CINAHL, ISC and the Cochrane Library using keywords including "brain", "neurobiochemical marker", "neurocritical care", and "S100B protein". The integrative review included 48 studies until March 2017. S100B protein can be considered as a marker for blood brain barrier damage. The marker has an important role in the development and recovery of normal central nervous system (CNS) after injury. In addition to extra cerebral sources of S100B, the marker is principally built in the astroglial and Schwann cells. The neurobiochemical marker, S100B, has a pathognomonic role in the diagnosis of a broad spectrum of brain damage including traumatic brain injury (TBI), brain tumor, and stroke. Moreover, a potential predicting role for the neurobiochemical marker has been presumed in the efficiency of brain damage treatment and prognosis. However further animal and human studies are required before widespread routine clinical introduction of S100 protein.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526782PMC
April 2017

Childhood Epilepsy; Prognostic Factors in Predicting the Treatment Failure.

Iran J Child Neurol 2017 ;11(1):21-28

Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Pediatric Neurology Department, Mofid Children's Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objective: We aimed to find the prognostic factors to detect the patients who fail the treatment of epilepsy, in the early stages of the disease.

Materials &methods: This study was done on the epileptic patients attending the Neurology Clinic of Mofid Children's Hospital, Tehran, Iran from September 2013 to October 2014. After defining the criteria for exclusion and inclusion, the patients were divided to two groups based on responding to the medical treatment for their epilepsy and indices were recorded for all the patients to be used in the statistical analyses.

Results: The patients' age ranged from 1 to 15 yr. There was 188 patients with refractory seizure in group 1 (experimental group) and 178 patient with well controlled seizure in group 2(control group).There was a significant different between serum drug level in both groups and patients with refractory seizure group had a lower serum drug level than control group. In both groups tonic-clonic was the most common type of seizure. Also the prevalence of brain imaging Abnormalityand other neurologic disorders was significantly higher in patients with refractory seizure in compare with control group.

Conclusion: Children with seizure who suffer from refractory epilepsy need more attention and exact observation by the medical staff.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329756PMC
January 2017

Persian version of frontal assessment battery: Correlations with formal measures of executive functioning and providing normative data for Persian population.

Iran J Neurol 2016 Jan;15(1):16-22

Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Cognitive impairment in patients with Parkinson's disease (PD) mainly involves executive function (EF). The frontal assessment battery (FAB) is an efficient tool for the assessment of EFs. The aims of this study were to determine the validity and reliability of the psychometric properties of the Persian version of FAB and assess its correlation with formal measures of EFs to provide normative data for the Persian version of FAB in patients with PD.

Methods: The study recruited 149 healthy participants and 49 patients with idiopathic PD. In PD patients, FAB results were compared to their performance on EF tests. Reliability analysis involved test-retest reliability and internal consistency, whereas validity analysis involved convergent validity approach. FAB scores compared in normal controls and in PD patients matched for age, education, and Mini-Mental State Examination (MMSE) score.

Results: In PD patients, FAB scores were significantly decreased compared to normal controls, and correlated with Stroop test and Wisconsin Card Sorting Test (WCST). In healthy subjects, FAB scores varied according to the age, education, and MMSE. In the FAB subtest analysis, the performances of PD patients were worse than the healthy participants on similarities, fluency tasks, and Luria's motor series.

Conclusion: Persian version of FAB could be used as a reliable scale for the assessment of frontal lobe functions in Iranian patients with PD. Furthermore, normative data provided for the Persian version of this test improve the accuracy and confidence in the clinical application of the FAB.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852066PMC
January 2016

Listening natively across perceptual domains?

J Exp Psychol Learn Mem Cogn 2016 07 28;42(7):1127-39. Epub 2016 Jan 28.

Neuroscience Area, SISSA-International School for Advanced Studies.

Our native tongue influences the way we perceive other languages. But does it also determine the way we perceive nonlinguistic sounds? The authors investigated how speakers of Italian, Turkish, and Persian group sequences of syllables, tones, or visual shapes alternating in either frequency or duration. We found strong native listening effects with linguistic stimuli. Speakers of Italian grouped the linguistic stimuli differently from speakers of Turkish and Persian. However, speakers of all languages showed the same perceptual biases when grouping the nonlinguistic auditory and the visual stimuli. The shared perceptual biases appear to be determined by universal grouping principles, and the linguistic differences caused by prosodic differences between the languages. Although previous findings suggest that acquired linguistic knowledge can either enhance or diminish the perception of both linguistic and nonlinguistic auditory stimuli, we found no transfer of native listening effects across auditory domains or perceptual modalities. (PsycINFO Database Record
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http://dx.doi.org/10.1037/xlm0000226DOI Listing
July 2016

A new perspective on word order preferences: the availability of a lexicon triggers the use of SVO word order.

Front Psychol 2015 13;6:1183. Epub 2015 Aug 13.

Neuroscience Sector, International School for Advanced Studies-SISSA Trieste, Italy.

Word orders are not distributed equally: SOV and SVO are the most prevalent among the world's languages. While there is a consensus that SOV might be the "default" order in human languages, the factors that trigger the preference for SVO are still a matter of debate. Here we provide a new perspective on word order preferences that emphasizes the role of a lexicon. We propose that while there is a tendency to favor SOV in the case of improvised communication, the exposure to a shared lexicon makes it possible to liberate sufficient cognitive resources to use syntax. Consequently SVO, the more efficient word order to express syntactic relations, emerges. To test this hypothesis, we taught Italian (SVO) and Persian (SOV) speakers a set of gestures and later asked them to describe simple events. Confirming our prediction, results showed that in both groups a consistent use of SVO emerged after acquiring a stable gesture repertoire.
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http://dx.doi.org/10.3389/fpsyg.2015.01183DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534792PMC
August 2015